I’ve treated a lot of patients with sports related injuries and I’ve noticed a trend in recent years where more people are lifting weights. So, I wanted to talk about the exercise form I’ve noticed people doing in the gym that may be leading to a future injury. From a biomechanical stand point, there are little movements in some exercises that can cause great harm, especially if done over a long period of time. Now, don’t get me wrong I am definitely not saying I have the best form, but I have a lot of personal experience with injuries that I’ve learned from in addition to knowledge about physiology and experience with treating sports injuries.
In recent years I’ve noticed certain exercises become more and more popular in the gym. It wasn’t very long ago that the squat rack was the equipment in a gym that very few people touched. Now it seems that everyone is doing squats, deadlifts, and even Olympic lifts such as the clean and jerk. Done incorrectly, especially over a long period can cause injuries, so you may end up seeing someone like me or worse, an orthopedic surgeon to fix a tear. I felt it’s important to bring up because when doing these exercises people should be mindful of their biomechanics.
Possibly the most popular exercise at the moment, especially for women, is the squat. Many people would agree that the squat is likely the best exercise a person can do because of the many muscles involved during the movement. In the photo below, the position on the left is ideal. When the spine is bent too much forward like on the right, there is increased pressure placed on the discs. Now add a compressive force that a barbell gives and you are increasing the pressure significantly. This is how you can cause disc herniations, and over a long period disc and joint degeneration. Now, the worst movement for the spine is flexion and rotation. This is like compressing and shearing the discs. Keep this in mind the next time you have weight on your back.
Photo from http://crossfitsomerville.com. They also do a great job in describing
Bar placement on the upper back.
· Keep spine flat
· Focus on breathing, don’t hold your breath. As this will increase the abdominal pressure.
· Bending forward too much will cause you to extend the spine on the way up, leading to muscular strain or sprain of the connective tissue.
· Bending forward too much increases the disc pressure.
Another popular exercise to be careful with is the deadlift. Keep the back flat, don’t arch, and most importantly don’t extend lumbar spine at the top. Possibly the movement that makes me cringe in fear I am witnessing an injury happen is when someone extends the spine past neutral at the top of the lift. Not only is it not necessary to extend at the top, but it can cause issues to the spine. The muscles in the low back are responsible for extending the spine from a flexed position, so they are being worked the entire movement, so an additional extension at the top past neutral isn’t needed. Remember, the spine underload with improper form can lead to severe strains, sprains, and disc injuries.
The photo below is from https://stronglifts.com/deadlift/. They do a great job in showing textbook form for deadlifts. I recommend strongifts.com because they go into detail about technique.
The same can be said for the roman chair low back extension exercise. Especially when holding weight. Extending past the point of neutral isn’t necessary and will only jam and irritate the low back joints.
Good form not only prevents injury, but it engages the muscles fully.
Keep liftin’ !
References:
Kuo C-S, Hu H-T, Lin R-M, et al. Biomechanical analysis of the lumbar spine on facet joint force and intradiscal pressure - a finite element study. BMC Musculoskeletal Disorders. 2010;11:151. doi:10.1186/1471-2474-11-151.
Influence of varying muscle forces on lumbar intradiscal pressure: An in vitro study Wilke, Hans-Joachim et al.Journal of Biomechanics , Volume 29 , Issue 4 , 549 - 555